冠状动脉内支架术后心肌血流储备分数预测心脏事件的研究

【作者】 张俊杰；

【导师】 陈绍良；

【作者基本信息】 南京医科大学 ， 心血管内科， 2005， 硕士

【摘要】 目的 研究冠状动脉内支架术后即刻心肌血流储备分数(FFRmyo)对术后6个月主要不良心脏事件(MACE)的预测价值,并建立FFRmyo的界定值。 方法 2003年7月至2003年9月在我院住院的稳定性心绞痛患者中,连续入选79例单支冠状动脉病变患者,分别于冠状动脉内支架术前及术后即刻测定FFRmyo和定量冠状动脉造影(QCA)诸参数,术后临床随访6个月,随访主要不良心脏事件率(包括死亡、心肌梗死、再次靶病变血运重建以及再发心绞痛),并采用多元logistic回归分析主要不良心脏事件发生率与冠心病危险因素、FFRmyo及QCA诸参数之间的关系。 结果 76例患者完成了6个月的临床随访,有14例患者(18.4%)发生了主要不良心脏事件,其中10例再发心绞痛(13.1%),4例需再次行经皮冠脉介入术(5.3%);多元logistic回归分析显示:支架术后FFRmyo是术后6个月主要不良心脏事件的独立预测因子(P=0.004),其预测价值显著优于QCA测定的残余狭窄(RS);据ROC曲线得出FFRmyo的界定值为0.92。 结论 冠状动脉内支架术后即刻FFRmyo是判定术后6个月主要心脏不良事件的独立预测因子。更多还原

【Abstract】 Objective To determine the predictive value of myocardial fractional flow reserve (FFRmyo) on major adverse cardiac events (MACE) in patients with stable angina after coronary artery stenting.Methods Of patients with stable angina admitted to our department from July 2003 to September 2003, 79 patients with single vessel disease were enrolled into the present study. FFRmyo and angiographic findings by quantity coronary angiography (QCA) were calculated before and immediately after coronary artery stenting. Incidence of MACE was recorded during 6 months follow-up. Multistep logistic regression analysis was managed to determine coronary risk factors, FFRmyo and indexes by QCA.Results Of 79 patients, 76 patients completed clinical follow-up within 6 months. MACE was identified in 14 patients (18.4%), 10 of 14 patients experienced re-angina (13.1%), revascularization of target segment was needed in 4 patients (5.3%). By multistep logistic regress analysis, FFRmyo更多还原